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01-12-2020 | Alzheimer's Disease | Original Article

Survival analysis of patients with hip fracture, Shiraz, Iran

Authors: Najmeh Maharlouei, Fatemeh Jafarzadeh, Abbas Rezaianzadeh, Maryam Janfada, Amirreza Mesbahi, Hamid Namazi, Kamran B. Lankarani

Published in: Archives of Osteoporosis | Issue 1/2020

Abstract

Summary

This study aimed to determine factors affecting the survival of patients with hip fracture in Shiraz, Iran. Alzheimer’s disease, hypertension, and cardiovascular diseases were risk factors, while female gender and living with family members or in nursing homes were protective factors against mortality following hip fracture.

Purpose

Hip fractures are the most common orthopedic fractures in elderly. This study aimed to determine the factors affecting the survival of patients with hip fracture in Shiraz.

Methods

This historical cohort study was conducted in Shiraz, Iran. All patients with hip fracture who were admitted to any of the hospitals providing orthopedic services in Shiraz, from September 1, 2011, to August 30, 2012, were included in the study. The log rank test, Kaplan–Meier methods, and the univariate and multivariate Cox regression model were used for data analysis.

Results

A total of 631 patients were enrolled, of these, 264 (41.8%) were male. The mean age of patients was 74.9 ± 11.5. The patients’ survival rate after the 1st, 2nd, 3rd, 4th, and 5th year were 81.1%, 73.7%, 69.4%, 64.8%, and 60.2%, respectively. After adjusting data for age, Alzheimer’s disease (HR = 4.9, 95% CI 1.4–7.3, P = 0.023), hypertension (HR = 2.27, 95% CI 1.3–3.8, P = 0.003), and cardiovascular diseases (HR = 2.02, 95% CI 1.04–3.09, P = 0.039) remained as risk factors for mortality in patients with hip fracture. However, female patients (HR = 0.46, 95% CI 0.27–0.8, P = 0.006) and those who lived with family members or in nursing homes (HR = 0.43, 95% CI 0.19–0.92, P = 0.03) were protective factors.

Conclusion

This study showed that women are more likely to have hip fractures, but mortality among men is more observable. Alzheimer’s disease, hypertension, and cardiovascular diseases were considered as risk factors, while patients who were female and those who lived with the family member or in nursing homes had better survival.

Lehtonen, E.J.I., et al., Trends in surgical treatment of femoral neck fractures in the elderly. Einstein (Sao Paulo, Brazil), 2018. 16(3): p. eAO4351-eAO4351

Dhanwal DK, Dennison EM, Harvey NC, Cooper C (2011) Epidemiology of hip fracture: worldwide geographic variation. Indian journal of orthopaedics 45(1):15–22CrossRef

Sullivan KJ et al (2016) Demographic factors in hip fracture incidence and mortality rates in California, 2000-2011. J Orthop Surg Res 11:4–4CrossRef

Carpintero P, Caeiro JR, Carpintero R, Morales A, Silva S, Mesa M (2014) Complications of hip fractures: a review. World journal of orthopedics 5(4):402–411CrossRef

Banks E, Reeves GK, Beral V, Balkwill A, Liu B, Roddam A, Million Women Study Collaborators (2009) Hip fracture incidence in relation to age, menopausal status, and age at menopause: prospective analysis. PLoS Med 6(11):e1000181–e1000181CrossRef

Li S, Dai Z, Wu Q (2015) Effect of coffee intake on hip fracture: a meta-analysis of prospective cohort studies. Nutr J 14:38–38CrossRef

Hoidrup S et al (2000) Tobacco smoking and risk of hip fracture in men and women. Int J Epidemiol 29(2):253–259CrossRef

Kim BH, Lee S, Yoo B, Lee WY, Lim Y, Kim MC, Yon JH, Kim KM (2015) Risk factors associated with outcomes of hip fracture surgery in elderly patients. Korean journal of anesthesiology 68(6):561–567CrossRef

Marley WD, Kelly G, Thompson NW (2015) Alcohol-related fracture admissions: a retrospective observational study. The Ulster medical journal 84(2):94–97PubMedPubMedCentral

10.

Leung F et al (2010) Does timing of surgery matter in fragility hip fractures? Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 21(Suppl 4):S529–S534CrossRef

11.

Mears SC, Kates SL (2015) A guide to improving the care of patients with fragility fractures, edition 2. Geriatric orthopaedic surgery & rehabilitation 6(2):58–120CrossRef

12.

Bukata SV, Digiovanni BF, Friedman SM, Hoyen H, Kates A, Kates SL, Mears SC, Mendelson DA, Serna FH Jr, Sieber FE, Tyler WK (2011) A guide to improving the care of patients with fragility fractures. Geriatric orthopaedic surgery & rehabilitation 2(1):5–37CrossRef

13.

Nasab SAM, Khorramdin E (2017) The assessment of mortality and quality of life after intertrochanteric fracture of femur in patients older than 60 at Emam Khomeini Hospital of Ahvaz. Pakistan journal of medical sciences 33(4):895–898PubMedPubMedCentral

14.

Magaziner J, Chiles N, Orwig D (2015) Recovery after hip fracture: interventions and their timing to address deficits and desired outcomes--evidence from the Baltimore hip studies. Nestle Nutrition Institute workshop series 83:71–81CrossRef

15.

Riemen AHK, Hutchison JD (2016) The multidisciplinary management of hip fractures in older patients. Orthopaedics and trauma 30(2):117–122CrossRef

16.

Beaupre, L.A., Binder E.F., Cameron I.D., Jones C.A., Orwig D., Sherrington C., Magaziner J., Maximising functional recovery following hip fracture in frail seniors. Best practice & research. Clin Rheumatol, 2013. 27(6): p. 771–788

17.

Colón-Emeric CS (2012) Postoperative management of hip fractures: interventions associated with improved outcomes. BoneKEy reports 1:241–241CrossRef

18.

Choi HJ, Kim E, Shin YJ, Choi BY, Kim YH, Lim TH (2014) The timing of surgery and mortality in elderly hip fractures: a retrospective, multicenteric cohort study. Indian journal of orthopaedics 48(6):599–604CrossRef

19.

Streubel PN et al (2011) Mortality after distal femur fractures in elderly patients. Clin Orthop Relat Res 469(4):1188–1196CrossRef

20.

Keene GS, Parker MJ, Pryor GA (1993) Mortality and morbidity after hip fractures. Bmj 307(6914):1248–1250CrossRef

21.

Baudoin, C., et al., Clinical outcomes and mortality after hip fracture: a 2-year follow-up study. Bone, 1996. 18(3 Suppl): p. 149s–157s

22.

Rahnavard Z et al (2009) The incidence of osteoporotic hip fracture: Iranian multicenter osteoporosis study (IMOS). Res j Biol sci 4(2):171–173

23.

Yeganeh A, Khatami F, Abolghasemian M (2014) Mortality rate in the first year after hip fracture in 65 year old or older patients in Rasool Akram hospital (Tehran). Babol-Jbums 16(1):112–116

24.

Rath S, Yadav L, Tewari A, Chantler T, Woodward M, Kotwal P, Jain A, Dey A, Garg B, Malhotra R, Goel A, Farooque K, Sharma V, Webster P, Norton R (2017) Management of older adults with hip fractures in India: a mixed methods study of current practice, barriers and facilitators, with recommendations to improve care pathways. Arch Osteoporos 12(1):55–55CrossRef

25.

Rozell, J.C., et al., Recent advances in the treatment of hip fractures in the elderly. F1000Research, 2016. 5: p. F1000 Faculty Rev-1953

26.

Teng GG, Curtis JR, Saag KG (2008) Mortality and osteoporotic fractures: is the link causal, and is it modifiable? Clin Exp Rheumatol 26(5 Suppl 51):S125–S137PubMedPubMedCentral

27.

Alexiou KI, Roushias A, Varitimidis SE, Malizos KN (2018) Quality of life and psychological consequences in elderly patients after a hip fracture: a review. Clin Interv Aging 13:143–150CrossRef

28.

Guerra MTE et al (2016) One-year mortality of elderly patients with hip fracture surgically treated at a hospital in Southern Brazil. Rev Bras Ortop 52(1):17–23CrossRef

29.

Kilci, O., et al., Postoperative mortality after hip fracture surgery: a 3 years follow up. PLoS One, 2016. 11(10)

30.

Lee AYJ et al (2012) Five-year outcome of individuals with hip fracture admitted to a Singapore Hospital: quality of life and survival rates after treatment. J Am Geriatr Soc 60(5):994–996CrossRef

31.

Sheikh HQ, Hossain FS, Aqil A, Akinbamijo B, Mushtaq V, Kapoor H (2017) A comprehensive analysis of the causes and predictors of 30-day mortality following hip fracture surgery. Clinics in orthopedic surgery 9(1):10–18CrossRef

32.

Franco LG, Kindermann AL, Tramujas L, de Souza Kock K (2016) Factors associated with mortality among elderly people hospitalized due to femoral fractures. Rev Bras Ortop 51(5):509–514CrossRef

33.

Oh ES, Sieber FE, Leoutsakos JM, Inouye SK, Lee HB (2016) Sex differences in hip fracture surgery: preoperative risk factors for delirium and postoperative outcomes. J Am Geriatr Soc 64(8):1616–1621CrossRef

34.

Kannegaard PN, van der Mark S, Eiken P, Abrahamsen B (2010) Excess mortality in men compared with women following a hip fracture. National analysis of comedications, comorbidity and survival. Age Ageing 39(2):203–209CrossRef

35.

Panula J et al (2011) Mortality and cause of death in hip fracture patients aged 65 or older: a population-based study. BMC Musculoskelet Disord 12:105–105CrossRef

36.

Chang W, Lv H, Feng C, Yuwen P, Wei N, Chen W, Zhang Y (2018) Preventable risk factors of mortality after hip fracture surgery: systematic review and meta-analysis. Int J Surg 52:320–328CrossRef

37.

Baker NL, Cook MN, Arrighi HM, Bullock R (2011) Hip fracture risk and subsequent mortality among Alzheimer’s disease patients in the United Kingdom, 1988-2007. Age Ageing 40(1):49–54CrossRef

38.

Norring-Agerskov D, Madsen CM, Bathum L, Pedersen OB, Lauritzen JB, Jørgensen NR, Jørgensen HL (2019) History of cardiovascular disease and cardiovascular biomarkers are associated with 30-day mortality in patients with hip fracture. Osteoporos Int 30(9):1767–1778CrossRef

Title: Survival analysis of patients with hip fracture, Shiraz, Iran
Authors: Najmeh Maharlouei
Fatemeh Jafarzadeh
Abbas Rezaianzadeh
Maryam Janfada
Amirreza Mesbahi
Hamid Namazi
Kamran B. Lankarani
Publication date: 01-12-2020
Publisher: Springer London
Keywords: Alzheimer's Disease
Alzheimer's Disease
Published in: Archives of Osteoporosis / Issue 1/2020
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-020-00714-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Survival analysis of patients with hip fracture, Shiraz, Iran

Abstract

Summary

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Purpose

Methods

Results

Conclusion

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